By the end of 2006, UNAIDS estimated that more than 40 million people are living with HIV/AIDS worldwide, of which 2.3 million are children. There are estimated 130,000 HIV-infected children in South and Southeast Asia. The standard of care for HIV-infected children includes antiretroviral treatment (ART), prophylaxis for opportunistic infections, and also nutritional support. Deficiencies in antioxidants during HIV infection facilitate the development of oxidative stress and may thus contribute to immune dysregulation and HIV replication. Few studies have examined the hypothesis that deficiencies in selenium and zinc, important antioxidants contribute to worse clinical outcomes. The overall goal of this study is to characterize role of micronutrients to HIV disease progression and response to ART among HIV-infected children in Thailand and Cambodia. The specific aims are (1) to evaluate the effect of selenium and zinc levels on response to ART, (2) to evaluate the effect of selenium and zinc levels on immunologic progression and (3) to correlate the selenium and zinc status to growth and neurocognitive functions. The proposed study will be conducted as a substudy of the well-established cohort of the Pediatric Randomized of Early versus Deferred Initiation in Cambodia and Thailand, the PREDICT study, which is co-funded by NIAID, NICHD and NIMH. This cohort provide us unique opportunity to study impact of nutritional factors to response to ART (early arm) and also impact to disease progression (deferred arm). Furthermore, the important factors include growth, neurodevelopment, immunological and virological parameters have been collected in the main PREDICT study. A comprehensive understanding of the impact of nutrition to HIV infection will lead to development of appropriate interventions to improve micronutrients intake and status that could contribute to a reduction in the impact of the HIV pandemic.Project Narrative The overall goal of this study is to characterize role of micronutrients to HIV disease progression and response to ART among HIV-infected children in Thailand and Cambodia. A comprehensive understanding of this issue will lead to development of appropriate interventions to improve micronutrients intake and status that could contribute to a reduction in the impact of the HIV pandemic. [unreadable] [unreadable] [unreadable]